Provider Demographics
NPI:1467528216
Name:DRUSCHEL, MICHELE L (LMP, LMT)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:L
Last Name:DRUSCHEL
Suffix:
Gender:F
Credentials:LMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 NE WHITMAN AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-7145
Mailing Address - Country:US
Mailing Address - Phone:360-253-2651
Mailing Address - Fax:
Practice Address - Street 1:1701 E EVERGREEN BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4232
Practice Address - Country:US
Practice Address - Phone:360-798-3372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00015210225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist